Weight gain and sudden infant death syndrome: changes in weight z scores may identify infants at increased risk

AIMS To investigate patterns of infant growth that may influence the risk of sudden infant death syndrome (SIDS). DESIGN Three year population based case control study with parental interviews for each death and four age matched controls. Growth was measured from prospective weight observations using the British 1990 Growth Reference. SETTING Five regions in England (population greater than 17 million, more than 470 000 live births over three years). SUBJECTS 247 SIDS cases and 1110 controls. RESULTS The growth rate from birth to the final weight observation was significantly poorer among the SIDS infants despite controlling for potential confounders (SIDS mean change in weight z score (δzw) = −0.38 (SD 1.40)v controls = +0.22 (SD 1.10), multivariate: p < 0.0001). Weight gain was poorer among SIDS infants with a normal birth weight (above the 16th centile: odds ratio (OR) = 1.75, 95% confidence interval (CI) 1.48–2.07, p < 0.0001) than for those with lower birth weight (OR = 1.09, 95% CI 0.61–1.95, p = 0.76). There was no evidence of increased growth retardation before death. CONCLUSIONS Poor postnatal weight gain was independently associated with an increased risk of SIDS and could be identified at the routine six week assessment. Key messages The lower weight of SIDS infants compared to the control infants which was apparent at birth was even more notable in the two weeks before death SIDS infants, particularly those of normal birth weight, exhibited poorer weight gain than their controls Although poor growth was evident among SIDS infants there was no evidence of accelerated retardation in the weeks prior to death The difference in growth between SIDS and control infants was apparent within the first five to seven weeks of life

[1]  G. Nagy,et al.  Evidence of Prolactin Immunoreactivity in the Bone Marrow of Untreated Multiple Myeloma Patients , 2001, Neuroimmunomodulation.

[2]  J. Davis.  Unexplained deaths in infancy , 1999, The Lancet.

[3]  T. Cole.  Growth monitoring with the British 1990 growth reference , 1997, Archives of disease in childhood.

[4]  E. Mitchell,et al.  Growth and the sudden infant death syndrome , 1996, Acta paediatrica.

[5]  J Golding,et al.  Environment of infants during sleep and risk of the sudden infant death syndrome: results of 1993-5 case-control study for confidential inquiry into stillbirths and deaths in infancy , 1996, BMJ.

[6]  T J Cole,et al.  Conditional reference charts to assess weight gain in British infants. , 1995, Archives of disease in childhood.

[7]  R. Carpenter,et al.  Reducing postneonatal mortality in West Virginia: a statewide intervention program targeting risk identified at and after birth. , 1995, American journal of public health.

[8]  R. Gilbert,et al.  Postnatal growth preceding sudden infant death syndrome. , 1994, Pediatrics.

[9]  R. Carpenter,et al.  Evaluation of attempted prevention of unexpected infant death in very high‐risk infants by planned health care , 1993, Acta paediatrica.

[10]  M Lampl,et al.  Saltation and stasis: a model of human growth. , 1992, Science.

[11]  R. Gilbert,et al.  Combined effect of infection and heavy wrapping on the risk of sudden unexpected infant death. , 1992, Archives of disease in childhood.

[12]  I. Kelmanson.  Differences in somatic and organ growth rates in infants who died of sudden infant death syndrome , 1992, Journal of perinatal medicine.

[13]  Janet Badcock.  Health for all children. , 1990, Archives of disease in childhood.

[14]  B. Taylor,et al.  Growth velocity before sudden infant death. , 1990, Archives of disease in childhood.

[15]  L. Becker,et al.  Assessment of growth in sudden infant death syndrome. , 1990, Neuroepidemiology.

[16]  T. Peters,et al.  What else do SIDS risk prediction scores predict? , 1985, Early human development.

[17]  R. Carpenter,et al.  Apnoea monitors compared with weighing scales for siblings after cot death. , 1985, Archives of disease in childhood.

[18]  M. Sakanoue.  [Sudden infant death syndrome]. , 1985, [Kango gijutsu] : [Nursing technique].

[19]  J. Hilden,et al.  SUDDEN INFANT DEATH IN COPENHAGEN 1956–1971 , 1982, Acta paediatrica Scandinavica.

[20]  J. M. Cameron,et al.  Foundation for the Study of Infant Deaths , 1971, Health visitor.

[21]  J. Hilden,et al.  SUDDEN INFANT DEATH IN COPENHAGEN 1956–1971 , 1978, Acta paediatrica Scandinavica.

[22]  R. Naeye,et al.  Sudden infant death syndrome. A prospective study. , 1976, American journal of diseases of children.

[23]  J. Emery,et al.  Evidence of duration and type of illness in children found unexpectedly dead. , 1976, Archives of disease in childhood.

[24]  A. Banks.  An enquiry into sudden death in infancy. , 1958, Monthly bulletin of the Ministry of Health and the Public Health Laboratory Service.